Hypertension and its Management
NATIONAL JOURNAL OF HOMOEOPATHY 1996 Jan / Feb Vol V No 1.
Sayali Prabhu

Blood pressure is defined as a lateral pressure exerted by blood column on the arterial wall.
Blood Pressure is of two kinds-1) Diastolic Pressure,2)Systolic Pressure.
The normal levels of Blood Pressure are Diastolic Pressure-80 mm of Hg and Systolic Pressure-120 mm of Hg. These values may vary according to the age, sex, occupation,diet, daily exercise and mental status of the individual.
Whenever there is change in these normal values ie when the Blood Pressure goes above 140/90 mm of Hg, it is considered as abnormal and this condition is called as Hypertension.
Hypertension is classified into-A) Primary/ Essential hypertension and B)Secondary hypertension.

CAUSES:

1. Primary Hypertension-No cause at all. The Blood Pressure is high without any physical complaints.
2. Secondary Hypertension.

1. Renal; Hydronephrosis, Renal artery stenosis, glomerulo-nephritis, Polycystic renal diseases diabetes.
2. Endocrinal-Cushings syndrome, adrenal carcinoma, hyperparathyroidism, hypothyroidism, Pheochromocytoma.
3. Cardio-vascular-Raised systolic pressure in aortic regurgitation or in complete heart block, coarctation of aorta.
4. Cerebral-Cerebral trauma, encephalitic, Increased intercranial pressure due to any causes, bulbar poliomyelitis.
5. Toxic-Toxemia of pregnancy, Intake of oral contraceptives steroids or lead toxicity, estrogen therapy.
6. Polycythemia vera.

Out of all the above types, essential hypertension is commonly seen. Most of the times such causes are ignored and patient comes with the complications. Thus, knowledge about the type and its management must be included in the dictionary of every Physician.

Essential Hypertension:.

Aetiology-

1. Hereditary factor-commonly seen in the children of hypertensive patients, twins. Thus is due to abnormality in trans-cellular sodium transport which is one of the genetic defect.
2. Environmental factor-
   1. Mental-Stress stress in every day life is one of the most common aetiological factors found in todays busy life.
   2. High sodium intake-Excessive intake of salt through pickles, papads, fast goods, juices and over use of salt in daily diet.
3. Low potassium diet.
4. Alcohol-Alcoholics often suffer from hypertension. Even though alcohol doesnt act as a direct aetiological factor of hypertension, yet it is seen during the withdrawal stage which is mediated by sympathetic Nervous system.
5. Obesity-caused due to more salt and carbohydrate intake.
6. Smoking.

PATHOGENESIS:

Sodium transport hypothesis is commonly accepted.

Stress and more salt intake activates the sympathetic Nervous system and causes vaso-constriction of renal efferent arterioles.

Due to stress Angiotension II, an active component of renin-angiotension system is secreted which leads to sodium and water retention ultimately causing the vasoconstriction.

The increased sodium intake and defective sodium transport leads to accumulation of sodium in intracellular compartment finally leading to hypertension.

CLINICAL FEATURES:

Most of the times it is asymptomatic but occasionally patient may complain of headache, heaviness of head, giddiness, palpitation, paroxysmal nocturnal dyspnoea.

EXAMINATION FINDINGS:

1. Blood Pressure level of Diastolic Pressure is important and according to its level the patients are grouped into
   Mild-Diastolic Pressure less than 100
   Moderate-Diastolic Pressure less than 100-120
   Severe-Diastolic Pressure more than 140
   Gross-Diastolic Pressure more than 140.
2. Pulse-Radial pulse bounding and hard.
3. CVS-Heaving cardiac impulse.
4. Optic fundi exam-arteriolar narrowing, compression, haemorrhage or oedema of disc may be seen.
5. ECG-Left ventricular enlargement with or without T inversion in Lead I, AVL, V5 and V6.
6. X ray chest-Left ventricle is dense, its left border is rounded.

COMPLICATIONS:

1. Arteriosclerosis.
2. Arteriolar inflammation.
3. Heart failure.
4. Angina
5. Cerebro vascular accident-cerebral haemorrhage, thrombosis and subarachnoid haemorrhage.
6. Hypertensive encephalopathy.
7. Hypertensive encephalopathy.
8. Renal damage.
9. Haemorrhage-epistaxis, haematemesis, haemoptysis.
10. Reduced life expectancy.

MANAGEMENT:

1. Medical observation.
2. Avoid mental and physical strain.
3. Overeating.
4. Smoking.
5. Weight reduction in obese patients.
6. Salt restriction.

HOMOEOPATHIC MANAGEMENT:.

homoeopathic management plays an important role in the case of hypertension.

Constitutional treatment is the best way of treating the hypertensive patient in cases of essential hypertension along with the general management given above.

Of course the treatment varies according to its cause whether it may be primary or secondary type of hypertension.

Mother tinctures also have a great role in controlling the hypertension along with the constitutional treatment. The following are useful in these cases:-

1. Veratrum- viride-Helps in reducing both diastolic and systolic blood pressure. Helps to reduce blood pressure in 4-5 hours.
2. Crataegus-Best used along with constitutional treatment. High arterial tension. Also helps in dissolving crustaceous and calcareous deposits in arteries. Irregular pulse.
3. Lycopus-vir-Lowers blood pressure, reduces the rate of heart and increases the length of systole.
4. Rauvolfia-serpentina

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